[Increasing immunization coverage by intervening on determinants of refusal]. / Aumentare le coperture vaccinali intervenendo sui determinanti del rifiuto.

With the regional decree 3664/2008, the Veneto Region adopted measures for improvements in the immunization program, among which the "Investigation into determinants for vaccine refusal in the Veneto Region", entrusted by the Department of Prevention Local Health Unit 20 (Ulss 20) of Verona. The objective of the study was to understand which type of parent that accessed immunization services (total adherent, partial adherent or complete refusals) and what factors lead to their choice regarding immmunizations in order to better plan strategies to maintain vaccination coverage.

Psychological performance of workers with blood-lead concentration below the current threshold limit value.

The effects of lead exposure on psychological test performance and subjective feelings of well-being were investigated in 40 exposed workers whose PbB levels had never exceeded 60 micrograms/100 ml and in 20 controls matched for sex, age and educational level. The exposed workers were divided into two groups of 20, with recent PbB levels in the range 45-60 micrograms/100 ml or below 35 micrograms/100 ml. The group of workers with the higher PbB levels showed significantly poorer performance and reported more physical symptoms than the other two groups. These differences were unrelated to sociodemographic and personality characteristics. A principal component analysis suggested that the poorer performance was mainly due to an impairment of general functioning and only to some extent to a deterioration in specific functions, such as verbal reasoning and abstraction. Higher lead concentrations were correlated with poorer performance and a higher number of physical complaints. These results indicate that in exposed workers the threshold for impaired performance lies below the blood-lead concentration of 60 micrograms/100 ml, which is the current threshold limit value (TLV).

Psychological and physical complaints of subjects with low exposure to lead.

The relationship between lead uptake level and subjective psychological and physical symptoms was investigated in two groups of occupationally exposed workers with PbB levels between 45 and 60 micrograms/100 ml and below 35 micrograms/100 ml respectively. Findings were compared with those of a non-exposed control group. Psychological symptomatology as defined by the GHQ proved unsensitive to low levels of lead exposure, while physical symptomatology as defined by the SSQ, in particular neurological symptoms, showed a significant tendency towards an uptake response relationship. The minimum uptake level for neurological symptoms in this study was below 35 micrograms/100 ml.